PrimeAnswers: A practical interface for answering primary care questions

Abstract

This paper describes an institutional approach taken to build a primary care reference portal. The objective for the site is to make access to and use of clinical reference faster and easier and to facilitate the use of evidence-based answers in daily practice. Reference objects were selected and metadata applied to a core set of sources. Metadata were used to search, sort, and filter results and to define deep-linked queries and structure the interface. User feedback resulted in an expansion in the scope of reference objects to meet the broad spectrum of information needs, including patient handouts and interactive risk management tools. RESULTS of a user satisfaction survey suggest that a simple interface to customized content makes it faster and easier for primary care clinicians to find information during the clinic day and to improve care to their patients. The PrimeAnswers portal is a first step in creating a fast search of a customized set of reference objects to match a clinician's patient care questions in the clinic. The next step is developing methods to solve the problem of matching a clinician's question to a specific answer through precise retrieval from reference sources; however, lack of internal structure and Web service standards in most clinical reference sources is an unresolved problem.

Figure 1.

PrimeAnswers Portal: http://primeanswers.org. Most clinicians use the interface by typing one or two words in the PrimeEvidence search box; in this example, osteoporosis screening.

Figure 2.

Search results from the filtered set of PrimeAnswers reference objects are displayed. A secondary option to run the same term(s) in four external sources was a clinician-requested feature.

Figure 3.

A bottom-line answer for reference objects in PrimeAnswers is provided. The actual bottom line is provided within the system if allowable or alternatively a link to the specific section within an external document if anchor tags are provided.

Figure 4.

User interactions, March 2002–February 2003.